Apparatus and method for imaging an eye

ABSTRACT

A slit lamp mounted eye imaging, a slit lamp integrated, a handheld, OCT integrated, or attached to a separate chinrest-joystick assembly apparatus and method for producing a wide field and/or magnified views of the posterior or the anterior segments of an eye through an undilated or dilated pupil is disclosed. The apparatus images sections and focal planes and utilizes an illumination system that uses one or more LEDs, shifting optical elements, flipping masks, and/or aperture stops where the light can be delivered into the optical system on optical axis or off axis from center of optical system and return imaging path from the eye, creating artifacts in different locations on the eye image. Image processing is employed to detect and eliminate artifacts and masks from images. The apparatus can be used in combination with an OCT, microscope and can be disposed in a hand-held housing for hand-held use.

The present application is a Continuation-In-Part application to U.S.Non-Provisional application Ser. No. 13/053,934 filed on Mar. 22, 2011Now U.S. Pat. No. 8,714,743 B2. The present application claims priorityto U.S. Provisional Application 61/316,677 filed on Mar. 23, 2010, bothdisclosures are incorporated by reference herein.

TECHNICAL FIELD & BACKGROUND

Imaging the eye is challenging with regard to obtaining images that areof good quality, that include a wide field of view, that are free ofcentral and other artifacts, that are in stereo, that can be obtainedwith ease of operator use, that can achieve proper alignment, focus andexposure for both dilated and undilated pupils in the posterior andanterior segments of the eye.

The present invention generally relates to a system and method forimaging an eye. The present invention provides a combination ofinnovative optical, mechanical, and image processing techniques thatinclude utilizing optical technologies combined with various imageprocessing techniques to obtain artifact-free images. More specifically,the invention is a system and method for imaging an eye that can beutilized in different operating modes and configurations that include ahand-held, microscope-mounted, integrated with optical coherencetomography (OCT) devices, integrated with direct and indirectophthalmoscopes, a slit lamp mounted, a slit lamp integrated or attachedto a separate chinrest-joystick assembly (fundus camera) configurationincluded with a plurality of accessories. The invention is able to imagepatients free of optical and other artifacts and also achieve wide fieldof view compared with current fundus cameras and other eye imagingdevices.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be described by way of exemplary embodiments,but not limitations, illustrated in the accompanying drawing in whichlike references denote similar elements, and in which:

FIG. 1A illustrates a side perspective view of an apparatus for imagingan eye utilized in combination with a computer, in accordance with oneembodiment of the present invention.

FIG. 1B illustrates a side perspective view of a camera housing, inaccordance with one embodiment of the present invention.

FIG. 1C illustrates a front overhead perspective view of an eyecup, inaccordance with one embodiment of the present invention.

FIG. 1D is an exploded diagonal side perspective diagram of a computersystem, in accordance with one embodiment of the present invention.

FIG. 2 illustrates a side perspective view of an apparatus for imagingan eye utilized in combination with a microscope, in accordance with oneembodiment of the present invention.

FIG. 3 illustrates a side perspective view of an apparatus for imagingan eye that is hand-held, in accordance with one embodiment of thepresent invention.

FIG. 4A is a flowchart of a method for producing an image of an eye, inaccordance with one embodiment of the present invention.

FIG. 4B illustrates a front perspective view of an eye image capture andartifact dots, in accordance with one embodiment of the presentinvention.

FIG. 4C illustrates a front perspective view of a flipping mask on aneye image capture, in accordance with one embodiment of the presentinvention.

FIG. 4D illustrates a front perspective view of artifact-free compositeeye image, in accordance with one embodiment of the present invention.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Various aspects of the illustrative embodiments will be described usingterms commonly employed by those skilled in the art to convey thesubstance of their work to others skilled in the art. However, it willbe apparent to those skilled in the art that the present invention maybe practiced with only some of the described aspects. For purposes ofexplanation, specific numbers, materials and configurations are setforth in order to provide a thorough understanding of the illustrativeembodiments. However, it will be apparent to one skilled in the art thatthe present invention may be practiced without the specific details. Inother instances, well-known features are omitted or simplified in ordernot to obscure the illustrative embodiments.

Various operations will be described as multiple discrete operations, inturn, in a manner that is most helpful in understanding the presentinvention. However, the order of description should not be construed asto imply that these operations are necessarily order dependent. Inparticular, these operations need not be performed in the order ofpresentation.

The phrase “in one embodiment” is used repeatedly. The phrase generallydoes not refer to the same embodiment, however, it may. The terms“comprising”, “having” and “including” are synonymous, unless thecontext dictates otherwise.

The apparatus for producing an image of an eye can be used for imagingthe eye and other medical applications, including but not limited toanterior segment imaging of a eye including but not limited to thecornea, lens, an anterior chamber, a tear film, and also a posteriorsegment imaging including color fundus, fluorescein angiography, and ICGangiography imaging, as well as red-free, blue, red, near infrared, andinfrared, spectral wavelengths of auto-fluorescence and functionalimaging, such as flavoprotein auto-fluorescence, fluorophores in theretinoid cycle and others, curcumin fluorescence imaging, and othercontrast agents used to image ocular and also neurodegenerativediseases. The apparatus for producing an image of an eye can be usedwith high magnification or can provide a very wide field of view and canbe operated in a zoom mode. The apparatus for producing an image of aneye can be operated in a plenoptic mode allowing various focal lengthsto be combined into a composite image that can be sectioned through, orcombined into a single image.

One embodiment of the apparatus for producing an image of an eye allowsfor use in a stereopsis mode for nearly real-time generation of stereoimages. The apparatus for producing an image of an eye can contain aneyecup to create a patient interface and darkened environment foroperation in a non-mydriatic mode. The eyecup can be utilized to hold aperson's eyelids open.

Another embodiment of the apparatus for producing an image of an eye canbe utilized as a treatment targeting and/or treatment planning system.

The apparatus for producing an image of an eye is a low cost, hand-heldand/or slit lamp mounted integrated and/or chinrest joystick assemblymounted, and/or microscope mounted eye imaging device suited for viewinga wide field and/or magnified views of retinal images through anundilated or dilated pupil.

The apparatus for producing an image of an eye is also capable ofimaging the anterior segment of the eye as well, and sections and focalplanes disposed between the sections. The apparatus for producing animage of an eye includes an illumination system, such as a LED, Halogen,Xenon, or other suitable illumination system, aperture stops andreflection masks. The illumination system includes one or more lightsources, preferably white LED light or light of an individual wavelengthfor specific tests, or tunable light sources, that can be delivered intothe optical system either along an optical axis or slightly off theoptical axis from the center of the optical system or eye and return theimaging path from the retina.

The apparatus for producing an image of an eye provides entry of lightrays into the eye for wide field retinal illumination, reduced glare andelimination of primary artifacts and reflections. Aperture stops,flipping masks, image processing, and/or off-axis illuminationeliminates unwanted reflections or glare from being formed in theretinal image. The apparatus for producing an image of an eye is wellsuited for retinal viewing through an undilated pupil, such as anon-pharmacologically dilated pupil or a pupil dilated as small as 1.5mms. and provides that the apertures and masks are sized in accordancewith the diameter of an undilated pupil. The adjustment of this apertureand/or masks may be fixed or may be adjusted by the user. It also mayautomatically sense pupil size and self-optimize the size of theaperture and/or masks, and position of the light source, and masks. Theapparatus for producing an image of an eye may utilize a reflection maskthat momentarily blocks unwanted reflections while still leaving otherareas of the image illuminated. Artifact-free regions from sequentialimages can also be combined to form a composite artifact-free image. Theapparatus for producing an image or continuous movie of an eye mayutilize a means of tracking the eye and adjusting to different viewsthereby moving artifacts to different geographic regions in the eye, andsubsequently combining those images or sections of images into a finalcomposite image that is artifact-free.

Another embodiment of the apparatus for producing an image of an eyeutilizes one, two or more sources of illumination with a lateral shiftand/or rotation of optical elements to shift the illumination and/orfield of view, combined with fast sequential mask flipping. Theseoptical designs also illuminate and provide an image with a wider fieldof view on the retina than current fundus cameras. Also, when images arecombined, a final image with more uniformly distributed illumination,sharper focus and aberration correction is created.

The apparatus for producing an image of an eye contains an imageprocessing algorithm that automatically detects any artifacts in theimage and performs an image reconstruction that uses the valid imageinformation from the corresponding image(s) where the artifact wasmasking the retina in the source image. The apparatus for producing animage of an eye may or may not utilize strobe lighting but does combineseveral images and blends the images together after performing similarartifact removal from one or more series of images, and/or changes inpatient fixation.

The optical design may contain one or more light sources and may add aprism, such as a half penta prism, Schmidt prism or custom-made prismthat redirects the illumination and imaging paths to be slightly offsetfrom each other, creating overlapping illumination and images for anincreased field of view, and also be utilized in combination withsequentially arranged flipping masks. These alternate illumination andimaging paths may enter the pupil in an angular way compared to theoptical center or may enter slightly off axis but parallel to the centerof the optical system. The angle of separation of these variousoverlapping light sources and imaging paths may be variable dependingupon pupil size. These may adjust automatically based upon automateddetection of pupil size.

Another embodiment of the apparatus for producing an image of an eyeaffords for tilting optical components to remove or specificallyposition reflections and artifacts. The apparatus for producing an imageof an eye contains a manual focus and/or an autofocus mechanism. Theapparatus for producing an image of an eye has an automatic exposurealgorithm and image brightness and contrast optimization algorithm tooptimize image quality. The apparatus for producing an image of an eyemay contain an image stabilization or eye tracking algorithm. Theapparatus for producing an image of an eye has an alignment mode ineither visible, NIR, or IR light that allows the user to align an eyeimage along an external pupil and/or infrared or visible light image ofthe retina. The apparatus for producing an image of an eye may containan alignment algorithm and mechanical or automated control for aligninga pupil of the eye along an optical axis to the patient's pupil.

The apparatus for producing an image of an eye may contain a spatiallight modulator for positioning and shaping the illumination beamaccording to the sensed location and dimensions of the pupil, incombination with a flipping mask for artifact removal. The apparatus forproducing an image of an eye may measure and record the pupil size. Theapparatus for producing an image of an eye may record pupillary responseto stimuli introduced into the optical train for purposes of perimetrytesting. The apparatus for producing an image of an eye may contain amode of dark adaptation testing that introduces a flash to bleach theretina followed by internal stimuli of various wavelengths to determinerod and/or cone response, especially in the tracking of age relatedmacular degeneration or AMD and other disease states. The apparatus forproducing an image of an eye may contain a mode of performing opticalcoherence tomography in combination with the other imaging modalities.The apparatus for producing an image of an eye may employ an infra-redor near infra-red filter or light source that is in place for alignmentmode and flipped out to allow other spectral wavelengths to pass andsubsequent image capture.

One embodiment of the apparatus for producing an image of an eye uses ananti-shake optical, eye tracking, and/or other image stabilizationsoftware algorithm to automatically align the apparatus for producing animage of an eye to the patient's eye and also eases alignment of imagesfor averaging and other image processing and viewing functions.

Another embodiment of the apparatus for producing an image of an eyethat achieves optical artifact shifting via an oscillating objectivelens or other internal optical or masking element that achievesproducing an image located adjacent to the artifact produced by theoscillating objective lens. Real-time artifact remapping may be appliedto this set of images for artifact elimination. This embodiment of theapparatus for producing an image of an eye affords for the creation ofreal-time stereo pairs of images due to oscillation and shifting.Oscillation could be of various frequencies to achieve a desired result.This may also be combined with eye tracking and changes in patientfixation in order to create a wide field view of the retina generatedfrom several images, movies, or sections of images either inpost-processing or near real-time.

Another embodiment of the apparatus for producing an image of an eyebuilds a comprehensive image through multiple planes of the eye bystepped focus and the introduction of additional optical elements toachieve focus shift.

Another embodiment of the apparatus for producing an image of an eyeutilizes all previously described modalities incorporated into atherapeutic planning and/or targeting system.

Fast sequential flipping of an artifact mask and subsequent imagereconstruction can be achieved with a variety of illumination strategiesaside from the point source illumination described. The mask can beimplemented by utilizing a mechanical flipping element, a shutteredopto-electronic window mechanism, or a rotating mask synchronized withan image capturing capability from one or more light sources. The areaunderneath the artifact would be temporarily exposed and captured, andsubsequently combined with other areas of previously acquired images forcreation of a composite artifact-free image. The mask could also serveas a patient fixation and/or eye alignment device or mechanism.

The apparatus for producing an image of an eye could contain a wirelessSD card or other embedded wireless device for automatically transmittingimages to a host computer or other storage device or software. Theapparatus for producing an image of an eye could allow the user to takean image of the patient's name, apply optical character recognitiontechnology, detect the patient's first name, last name and chart code,record the date and time of the image and automatically store theinformation in a database and wirelessly transmit the information to ahost. This could be performed by an embedded processor in the apparatusfor producing an image of an eye or by a host computer.

The apparatus for producing an image of an eye may also utilize aflexible eyecup that could be fixed to the apparatus for producing animage of an eye, or be utilized as a disposable flexible eyecup thatattaches to the end of the apparatus for producing an image of an eyefor use on each patient. The eyecup could be made of baffled flexiblematerial such as rubber, plastic, or any type of suitable material thatgently surrounds the patient's eye to create a darkened environment andcould also be used to hold a patient's eyelids open. The eyecup couldhave an angular spring internal mechanism (or sponge-like compressiblematerial) that holds the patient's eyelids open. The baffles areflexible to allow for adjustable and proper positioning around thepatient's eye.

One embodiment of the apparatus for producing an image of an eyecontains a firm rubber or plastic portion of the eyecup that is locatedapproximately along a vertical axis to the eyecup that is used to hold apatient's upper eyelid open during imaging. The rest of the eyecup isplaced over the patient's eye to create a darkened environment. Thismode of operation creates a darkened environment for natural pupildilation for the patient. Another embodiment of the eye cup is only theupper most portions used to hold the upper eye lid open during imaging.

The apparatus for producing an image of an eye could also include aninfrared or near-infrared LED light or other light source illuminationsystem, coupled with a detector, such as a charge coupled device or CCD,a complementary metal oxide semiconductor or CMOS, or other suitabletype of detector that is sensitive to light at a particular wavelength.The detector would be used for alignment, but could also be turned offand the patient would be flashed with visible light, green light, bluelight or red-free light wavelengths for imaging including fluoresceinangiography, ICG angiography, fundus auto fluorescence, hyper andmulti-spectral imaging, curcumin fluorescence imaging or otherwavelengths used in other auto fluorescence or functional imaging with avariety of contrast agents.

The apparatus for producing an image of an eye could have all of thepreviously described embodiments in addition to creating a multi-focalplenoptic image or other image or movie that is created from images atmultiple focal planes. This image is formed by a camera system that hasmicro-lenses over the top of a CCD or CMOS pixel array that is dividedinto two or more focal planes. This image would be calibrated andreconstructed into a multi-focal plenoptic image. Alternatively, aplenoptic multifocal image could be created by using a manual orauto-focus mechanism that finds optimal center focus and then acquiresadditional images with slight focus adjustments bracketed around thecenter focal point. These images could then be combined into a singleplenoptic image or could be combined into an interactive movie imagethat allows the user to scroll through multiple focal planes. Thealgorithm to combine images would automatically align the imagescorrecting for translation, rotation, curvature, and magnificationdifferences between the images. The software would detect high frequencyinformation in each image plane corresponding to an element. Theplenoptic algorithm could also be used for combining images of differentmodalities. For example, ICG images highlighting choroidal detail couldbe combined with fluorescein images highlighting retinal detail. Theplenoptic algorithm could be used for any combination of retinal images.The plenoptic algorithm could also be applied to images from multiplefocal planes in the anterior segment of the eye. These modalities couldalso be combined with OCT data sets for sectioned retinal images thatcontain multiple image planes and sections.

One embodiment would allow for a continuous capture of images or moviesthrough the entire eye from the anterior portion to the posteriorportion and allow for application of the plenoptic algorithm to form asingle plenoptic image or movie loop viewing function.

Another embodiment of the apparatus for producing an image of an eyeallows for simultaneous or fast sequential capture of multiple imagingmodalities and recombination into composite images as single frames oraveraged images.

Another embodiment of the apparatus for producing an image of an eyecould also be implemented in combination with a wave front sensor forautomated positioning and correction of aberrations. The apparatus forproducing an image of an eye could be combined with a deformable mirrorand wave front sensor for correction of both low and high orderaberrations. The apparatus for producing an image of an eye and all itsembodiments could include components, light sources and filters thatallow all retinal types of retinal imaging including but not limited tocolor fundus imaging, red-free, ICG angiography, fluoresceinangiography, IR or near IR imaging, all forms of fundus autofluorescence at various wavelengths, hyper and multi-spectral imaging,curcumin fluorescence imaging, and functional imaging with a variety ofcontrast agents.

Another embodiment of the apparatus for producing an image of an eyewould utilize elements of the imaging portions of the slit lamp and berotated in front of a slit lamp objective lens of the slit lamp.

Another embodiment of the apparatus for producing an image of an eyewould utilize modification of the slit lamp that also utilizes the slitlamp's existing illumination system for retinal and anterior segmentimaging.

Another embodiment of the apparatus for producing an image of an eyewould be for handheld use, integrated with a direct or indirectophthalmoscope, or having the apparatus for producing an image of an eyeconnected to a microscope.

Another embodiment of the apparatus for producing an image of an eyewould be to combine the apparatus for producing an image of an eye withoptical coherence tomography or OCT test modality.

Another embodiment of the apparatus for producing an image of an eyeutilizes a mode where images are captured and move together in realtime, real time movie streams are analyzed for artifacts and optimalfocus, and images are reconstructed from “good” sections of images takenfrom the movie stream.

Another embodiment of the apparatus for producing an image of an eyeallows the user to program an internal fixation target for the patientto follow and then attach images together as they are captured. Thiswould also be applied for artifact removal. Multiple images could bestored as a movie file, single frames or a single frame attachedtogether. The internal fixation could be in a variety of forms includinga flipping “stick” that contain an LED array that can be programmed bythe user to a specific position. The internal flipping LED stick isautomatically flipped out of place during image capture.

Another embodiment of the apparatus for producing an image of an eyeintroduces stimuli via a LCD light and a beam slitter or other suitablemechanism for microperimetry testing.

Another embodiment of the apparatus for producing an image of an eyeutilizes interchangeable objective lenses for different fields of viewand also for anterior segment imaging.

Another embodiment of the apparatus for producing an image of an eyeinclude lens, stops and a masking device that is optimized forretro-illumination imaging of the eye lens.

Another embodiment of the apparatus for producing an image of an eyeapplies a dark-correction algorithm whereby an image of the CCD or CMOSchip is captured in a darkened environment and is processed, stored anddeleted from captured images to reduce noise and improve overall imagequality.

Another embodiment of the apparatus for producing an image of an eyeallows utilization in a switchable normal focus or plenoptic mode toallow for capture of images from multiple focal planes.

Another embodiment of the apparatus for producing an image of an eyeutilizes a stereo optical system for real time stereoscopic viewing.This is achieved in a variety of different ways including optical shift,CCD lens overlay or micro lens overlay and can be derived from videoscanning, motion and/or focus cameras, multiple cameras, or multi-chipcameras.

Another embodiment of the apparatus for producing an image of an eyewould have dual stereo cameras (or dual chips/optics in a singlecamera). This can be mounted in the slit lamp through beam-splitter oroculars of a traditional slit lamp beam splitter.

Another embodiment of the apparatus for producing an image of an eyeinvolves an alternative to a rapid alternate strobing of an LED lightthat would instead utilize a rotating optic mask at a rapid pace that issynchronized with a video input. This would result in multiple imagesfor artifact-free reconstruction.

Another embodiment of the apparatus for producing an image of an eyeutilizes a rotating light source that can also be utilized incombination with other previously mentioned features. This can be donewith several optical elements in the apparatus for producing an image ofan eye including a rapidly rotating synchronized optic like a wedgeprism. The artifact would be mapped to the other image to remove theartifact. The mapping could be done with image processing or withcalibration and real-time memory mapping. The mapping also serves as ameans of increasing the field of view of the image and could be puttogether in a panorama as a single image.

Another embodiment of the apparatus for producing an image of an eyeuses any or all of the described elements and produces a panoramatogether in real time from the video stream. This could also be obtainedby a random or automated pre-programmed change in patient fixation. Thiscould also be achieved via a programmable swing and/or tilt of thedevice to change position and image view.

FIG. 1A illustrates an exploded perspective view of an apparatus forproducing an image of an eye 100, in accordance with one embodiment ofthe present invention. The apparatus for producing an image of an eye100 includes a video camera 110, video camera optics 112, a camerahousing 120 mounted on a slit lamp chinrest and joystick assembly 130and illumination source optics 140. The video camera 110 is a digitalcamera but can be any type of suitable camera for use with the apparatusfor producing an image of an eye 100. The slit lamp chinrest andjoystick assembly 130 includes a head support 142, a movable base 144, ajoystick 146, and a housing support 148. The head support 142 holds thepatient's chin and forehead in a known, fixed position. The head support142 is provided with elevation adjustments to provide a comfortableresting place for the patient's head. The position of the camera housing120 relative to the head support 142 can be adjusted in both relativegross and fine increments using the joystick 146. The apparatus forproducing an image of an eye 100 is used in combination with a computersystem 150, which is described in greater detail in FIG. 1D. Thecomputer system 150 can be any suitable computer system 150 that can beused in combination with the apparatus for imaging an eye 100.

The personal computer 150 forms the center of the apparatus for imagingan eye 100, processing data and controlling the operation of othercomponents of the apparatus for imaging an eye 100. Connected to thepersonal computer 150 is a video camera 110. An observation videomonitor which can be the screen of the personal computer, a slit lampchinrest and joystick assembly 130, illumination source optics 140, andvideo camera optics 112 are associated with the camera housing 120.

The personal computer 150 is preferably a relatively compact computer,embedded computer, or tablet computer of relatively high processingpower using a standardized operating system and having standardized cardslots for interfacing peripheral equipment such as memory cards, videoboard, printer and a monitor. The personal computer 150 will runcustomized software as will be described in detail later. The monitor orscreen of the personal computer will have very-high-resolution colorgraphics capability appropriate for displaying images under analysis.

The digitizing board accepts a digital file or video input from videocamera 110 and functions as a “frame grabber,” or display. That is, whenactivated by a signal from the personal computer 150, the digitizingboard will collect video and/or digital data and images from videocamera 110 at that instant and store into digital data. The digital dataproduced is stored in memory and made available to personal computer 150for analysis.

FIG. 1B illustrates a side perspective view of a camera housing 120 ofthe chinrest and joystick assembly 130, in accordance with oneembodiment of the present invention. The camera housing 120 containingthe video camera 110 illumination source(s) and optics 140 is proximateto a sectioned patient eyeball EB with a cornea C and a retina R.Housing 120 may be cylindrical or of any other suitable shape. Thehousing 120 has no forward protruding parts, which prevents accidentaldirect contact of any part of the apparatus for imaging an eye 100 withthe patient's cornea C or facial features during movement of the housing120 relative to the patient's eyes. This is advantageous since there isno contact with the patient's cornea C to accomplish examination andimage capture. The external housing 120 and the optics have beendesigned to maintain some distance to the cornea C, increasing patientcomfort while any testing is being performed. A flexible interface suchas a rubber cup 180 can be provided at the interface between the housing120 and the patient's eyeball EB.

The inclusion of illumination source optics 140, camera optics 112 andthe video camera 110 in the camera housing 120 provides a high degree ofaccessibility. By placing all elements of the apparatus for imaging aneye 100 in one camera housing 120, allows for an affordable design.Additionally, the relatively small design of the apparatus for imagingan eye 100 compared to that of a fundus camera for observation and imagecapture provides for a shorter and more efficient optical pathway. Thecompact design and simplicity of optics 112,140 reduces production costsand permits greater ease of use by the operator. The design of theapparatus for imaging an eye 100 allows imaging through a smaller pupilas compared to a fundus camera.

Video camera 110 is relatively compact and incorporates a color ormonochrome CCD, CMOS, or multi/hyper-spectral image sensor. The focus ofthe patient may also be achieved by focus of internal optical elementsof the digital camera. Lens contained inside camera 100 may be focusedautomatically or manually by observing the image displayed on anobservation video monitor. Alternatively, an electronic auto-focusingcontrol system could be provided for automatically adjusting the focusof lens inside camera 100. The video camera 110 can also contain amonochrome or color CCD or CMOS sensor (not shown).

The observation optics 112 associated with the video camera 110 includethe lens 170, an observation aperture 172, and a filter 174. Theobservation aperture 172 and the filter 174 transmit light reflectedfrom the retina R to the lens 170 and to the video camera 110. Thefilter 174 is an infrared stepping filter (or other filter for otherimaging procedures) which improves the contrast of the image seen by thevideo camera 110.

Indo-cyanine green angiography, color fundus photography,auto-fluorescence, or fluorescein angiography, curcumin fluorescenceimaging, or other filter sets may be utilized by the apparatus forimaging an eye 100. These filters will be mounted so as to beselectively rotatable in and out of the view axis of the video camera110 according to the function being performed. The rotation may beaccomplished manually or under computer servo control.

The projection optics 140 of the invention projects light onto theretina R, off axis at an angle to the central axis 176 of lens 170 ofvideo camera 110. The projection optics 140 includes a lamp 141, a lamplens group 143, a mirror 145, and a projection aperture 172. A control1001 is provided to adjust the intensity and position of the lamp 141,either manually or under the control of the computer system 150. Thecontrol is also used to sequentially control multiple lamps 141,shifting optical elements, and flipping masks 147, LED flipping internalfixation pointer 1004, and image capture trigger.

The light from lamp 141 passes through aperture 149 and the series oflamp lens group 143 that typically has two lenses. The lenses of lamplens group 143 concentrate the light output of lamp 141. Lamp lens group143 may preferably consist of multiple lenses or a single aspheric lens.The light is then deflected by mirror 145 which is placed at a criticalpitch angle relative to the video camera 110 and the projection optics112. The light passes from the mirror 145 past the flipping mask 147which concentrates the light. The light then passes through a pluralityof small pupil masks 1002. The light then passes through the objectivelens 1003. The light then passes past the cornea C and is projected ontoretina R.

All the masks and apertures used, such as flipping mask 147 and aperture149 and 1002, are appropriately sized apertures. Although the lamp 141has been described as a generalized LED lamp, it should be noted thatthe lamp 141 can be any source of radiant energy. In one preferredembodiment, the lamp 141 is an infrared illumination source, and thespecifications of filter 174 are adjusted accordingly to pass thewavelength of the lamp 141. Infrared illumination may be particularlydesirable for alignment prior to acquiring images without the problemsgenerated by lack of pupil dilation. The image can be captured in arelatively dark room using infrared illumination, so that the eye beingimaged is naturally dilated. There is also a means for sequentiallyturning the light source on and off in synchronization with imagecapture under each condition, which is a computer system 150, furtherdescribed in FIG. 1C.

In another preferred embodiment which addresses the problems caused bylack of pupil dilation during imaging, the lamp 141 may be strobed infull color, red free, NIR or other preferred wavelength (based onimaging procedure desired) during image acquisition rather than beingkept on constantly, thereby preventing the energy of lamp 141 fromnarrowing the pupil prior to image capture. Because of the unique designof the projection optics 140 and the capabilities of the imageprocessing and analysis software employed, useful image data from eachimage can be collected with minimum pupil dilation. Specifically, thepupils of the eye being imaged may have a diameter of as little as 2mms. The projection optics 140 projects light onto the retina R off axisfrom the observation path of video camera 110. Another preferredembodiment places an adjustable mask 1002 adjacent to objective lens1003 that adjust to the patient's pupil to optimize the image when thepupil is small.

FIG. 1C illustrates a front overhead perspective view of an eyecup 180,in accordance with one embodiment of the present invention. The eyecup180 protrudes outward from the perimeter 182 at an approximate 10%increase at the approximate 0° 184 and 180° degree 186 positions on theperimeter 182. Further details regarding the eyecup 180 are described inFIG. 3 and its description.

FIG. 1D is an exploded diagonal side perspective diagram of a computersystem 150, in accordance with one embodiment of the present invention.Such a computer system 150 includes a processing unit such as a CPU 151connected by a bus to a random access memory or RAM 152, a storagedevice 153, a keyboard 154, a display 155 and a mouse 156. In addition,there is software 157 for entry of data embodying the apparatus forimaging an eye 100. An example of a computer system 150 can be a Dellpersonal computer operating on the Microsoft Windows operating system,or Linux, Macintosh, etc. The invention can also be used on a laptopcomputer, cell phone, PDA, Apple™ Mac™, tablet, or other computerizeddevice. The computerized system 150 can also be used in combination witha wireless modem 158 or network interface card 159.

The various method embodiments of the invention will be generallyimplemented by a computer executing a sequence of program instructionsfor carrying out the steps of the method, assuming all required data forprocessing is accessible to the computer. The sequence of programinstructions may be embodied in a computer program product comprisingmedia storing the program instructions. As will be readily apparent tothose skilled in the art, the present invention can be realized inhardware, software, or a combination of hardware and software. Any kindof computer/server system(s)—or other apparatus adapted for carrying outthe methods described herein—is suited. A typical combination ofhardware and software could be a general-purpose computer system with acomputer program that, when loaded and executed, carries out the method,and variations on the method as described herein.

FIG. 2 illustrates a side perspective view of an apparatus for imagingan eye 200 utilized in combination with a microscope 260, in accordancewith one embodiment of the present invention. FIG. 2 illustrates a sideperspective view of an apparatus for imaging an eye 100 that has all ofthe same components of the apparatus for imaging an eye 100 described inFIG. 1A, except the microscope 260 and the computer system 150. Theapparatus for producing an image of an eye 200 includes a video camera210, video camera optics 212, a camera housing 220 mounted on a patientalignment assembly 230 and illumination source optics 240. Themicroscope assembly 230 includes a support 242, a movable base 244, andhousing support 248. The position of the camera housing 220 relative tothe head support 242 can be adjusted in both gross and fine incrementsusing the joystick 246. The microscope 260 can be any suitablemicroscope that can be used in combination with the apparatus forimaging an eye 200.

FIG. 3 illustrates a side perspective view of a hand held apparatus forimaging an eye 300, in accordance with one embodiment of the presentinvention. The hand held apparatus for imaging an eye 300 includes allof the same components of the apparatus for imaging an eye 100 describedin FIG. 1B and can be used in combination with a microscope 260 (FIG. 2)or a computer system 150 (FIG. 1A). The hand held apparatus for imagingan eye 300 utilizes a hand-held housing 310 instead of a camera housing120 as described in FIGS. 1A and 1B, but utilizes all of the sameoptical and electrical components disposed within the hand-held housing310.

The hand-held apparatus for producing an image of an eye 300 may alsoutilize a flexible eyecup 320 that could be fixed to the hand-heldapparatus for producing an image of an eye 300, or be utilized as adisposable flexible eyecup that attaches to the end 312 of the apparatusfor producing an image of an eye for use on each patient. The flexibleeyecup 320 could be made of baffled flexible material 322 such asrubber, plastic, or any type of suitable material that gently surroundsthe patient's eye to create a darkened environment and could also beused to hold a patient's eyelids open. The flexible eyecup 320 couldhave an angular spring internal mechanism 330 that holds the patient'seyelids open. The baffles 322 are flexible to allow for adjustable andproper positioning around the patient's eye.

FIG. 4A is a flowchart of a method for producing an image of an eye 400,in accordance with one embodiment of the present invention. The overallmethod 400 illustrates the architecture, functionality, and operation ofpossible implementations of systems, methods and computer programproducts according to various embodiments of the present invention. Inthis regard, each step in the method may represent a module, segment, orportion of code, which comprises one or more executable instructions forimplementing the specified logical function(s). It should also be notedthat, in some alternative implementations, the functions noted in thestep may occur out of the order. For example, two steps shown insuccession may, in fact be executed substantially concurrently, or thesteps may sometimes be executed in the reverse order, depending upon thefunctionality involved. It will also be noted that each step of theoverall method, and combinations of steps in the overall method, can beimplemented by special purpose hardware-based systems that perform thespecified functions or acts, or combinations of special purpose hardwareand computer instructions.

The overall method may be embodied as a system, method, or computerprogram product. Accordingly, the overall method may take the form of ahardware embodiment, a software embodiment, or an embodiment combiningsoftware and hardware. Furthermore, the overall method may take the formof a computer program product embodied in any tangible medium ofexpression having computer-usable program code embodied in the medium.

Any combination of one or more computer usable or computer readablemedium(s) may be utilized. Specific examples of the computer-readablemedium can include a hard disk, a random access memory (RAM), aread-only memory (ROM), an erasable programmable read-only memory(EPROM), or flash memory or a portable compact disc read-only memory(CD-ROM). In the context of this document, a computer-usable orcomputer-readable medium may be any medium that can be used by or inconnection with the instruction execution system or apparatus. Computerprogram code for carrying out operations of the overall method may bewritten in any combination of one or more programming languages. Theprogram code may execute entirely on the user's computer, partly on theuser's computer, as a stand-alone software package, partly on the user'scomputer and partly on a remote computer or entirely on the remotecomputer or server.

The overall method is described above with reference to a computerprogram according to an embodiment of the invention. It will beunderstood that each step, and combinations of steps shown, can beimplemented by computer program instructions. These computer programinstructions may be provided to a processor of a general purposecomputer, special purpose computer, or other programmable dataprocessing apparatus to produce a machine, such that the instructions,which execute via the processor of the computer or other programmabledata processing apparatus, create means for implementing the functionsspecified in the method.

These computer program instructions may also be stored in acomputer-readable medium that can direct a computer or otherprogrammable data processing apparatus to function in a particularmanner, such that the instructions stored in the computer readablemedium produce an article of manufacture including instructions meanswhich implement the function specified in the steps.

The computer program instruction may also be loaded onto a computer orother programmable data processing apparatus to cause a series ofoperational steps to be performed on the computer or other programmableapparatus to produce a computer implemented process such that theinstructions which execute on the computer or other programmableapparatus provide processes for implementing the functions specified.

In the first step 410, the patient's demographics are entered. Thepatient places his or her head in the slit lamp chinrest and joystickassembly so that the patient's head is held substantially immobile. Theoperator adjusts the position of housing adjustments on the chinrest andjoystick assembly and particularly using the joystick until theprojection optics and the video camera are aimed through one or theother of the patient's corneas of the eye. The image capture is begun420 and is triggered by the operator or automatically by the computerbased on an algorithm for optimal image alignment by the operatorpressing a button on the joystick, Bluetooth keypad, tablet computer, ortriggering a foot pedal to signal the apparatus that the image of videocamera should be recorded. Then an autofocus procedure and auto-exposureprocedure 430, 440 are executed to obtain a clear image of the patient'sretina. Illumination is then activated 450 and then either the opticalshift activated 460, or the flipping mask 147 (from FIG. 1B) is actuated(depending upon configuration).

FIG. 4B illustrates a front perspective view of an eye image capture 472and artifact dots 480, in accordance with one embodiment of the presentinvention. Subsequently the image capture is ended 470 and artifacts areidentified 480.

FIG. 4C illustrates a front perspective view of a flipping mask 485 onan eye image capture 490, in accordance with one embodiment of thepresent invention. After identifying artifacts the flipping mask 147 isidentified additionally well exposed focused portions of each image areidentified 490 and image sections are combined to create anartifact-free composite image 495. FIG. 4D illustrates a frontperspective view of the artifact-free composite eye image 495, inaccordance with one embodiment of the present invention. Theartifact-free composite image 495 is previously described in FIG. 4C.

In response to the indication of the operator (or via controller) theimage should be recorded, the personal computer will cause the image(s)of video camera to store digital data representing the capturedimage(s). The overall method 400 can also be used in combination with amicroscope. The overall method can be used with scanning the device viaswing or tilt mechanism or patient fixation.

While the present invention has been related in terms of the foregoingembodiments, those skilled in the art will recognize that the inventionis not limited to the embodiments described. The present invention canbe practiced with modification and alteration within the spirit andscope of the appended claims. Thus, the description is to be regarded asillustrative instead of restrictive on the present invention.

The invention claimed is:
 1. A method for producing an image of aposterior and an anterior segment of an eye in combination with an imageproducing apparatus, comprising the steps of: entering patientdemographics; beginning image or movie capture; optimizing masks andillumination position to pupil size; executing autofocus or intentionalfocus shift for plenoptic image; executing auto-exposure; activatingsequential illumination; activating optical shift; activating mask flip;ending image or movie capture; identifying artifacts, masks and clearportions of images; and combining said images sections to create anartifact-free composite, plenoptic, averaged, stereo image or movie. 2.The method according to claim 1, wherein said apparatus is a hand-heldapparatus either as a standalone device or incorporated with an existingdirect or an indirect ophthalmoscope.
 3. The method according to claim1, wherein said apparatus is used in combination with a microscope, aslit lamp, an OCT, a microscope, a direct or indirect ophthalmoscope, amicroperimetry device, or an existing fundus camera.
 4. The methodaccording to claim 1, wherein said apparatus is used in detectingamyloid in said retina.
 5. The method according to claim 4, wherein saidapparatus is used in said detecting of amyloid in said retina utilizinglight sources, filters, spectrometer and sensors that allow curcuminfluorescence imaging, auto fluorescence imaging, hyper-spectral imaging,multi-spectral imaging, or OCT and subsequent image segmentation toidentify amyloid associated with either ocular or brain conditions.
 6. Amethod for producing an image of a posterior and an anterior segment ofan undilated eye in combination with an image producing apparatus,comprising the steps of: entering patient demographics; beginning imageor movie capture; optimizing masks and illumination position to pupilsize; executing autofocus, or intentional focus shift for plenopticimage; executing auto-exposure; activating sequential illumination;activating optical shift; activating mask flip; ending image or moviecapture; identifying artifacts, masks and clear portions of images;identifying well focused and well illuminated portions of said images:and combining said image sections to create an artifact-free composite,plenoptic, averaged, stereo image or movie.
 7. The method according toclaim 6, wherein said apparatus is a hand-held apparatus either as astandalone device or incorporated with an existing direct or an indirectophthalmoscope.
 8. The method according to claim 6, wherein saidapparatus is used in combination with a microscope, a slit lamp, an OCT,a microscope, a direct or indirect ophthalmoscope, a microperimetrydevice, or an existing fundus camera.
 9. The method according to claim6, wherein said apparatus is used in detecting amyloid in said retina.10. The method according to claim 9, wherein said apparatus is used insaid detecting of amyloid in said retina utilizing light sources,filters, spectrometer and sensors that allow curcumin fluorescenceimaging, auto fluorescence imaging, hyper spectral imaging,multi-spectral imaging, or OCT and subsequent image segmentation toidentify amyloid associated with either ocular or brain conditions. 11.A non-transitory computer readable storage medium to produce an image ofa posterior and an anterior segment of an undilated eye in combinationwith an image producing apparatus, comprising the steps of: enteringpatient demographics; beginning image or movie capture; optimizing masksand illumination position to pupil size; executing autofocus, orintentional focus shift for plenoptic image; executing auto-exposure;activating sequential illumination; activating optical shift; activatingmask flip; ending image or movie capture; identifying artifacts, masksand clear portions of images; identifying well focused and wellilluminated portions of said images: and combining said image sectionsto create an artifact-free composite, plenoptic, averaged, stereo imageor movie.
 12. The non-transitory computer readable storage mediumaccording to claim 11, wherein said apparatus is a hand-held apparatuseither as a standalone device or incorporated with an existing direct oran indirect ophthalmoscope.
 13. The non-transitory computer readablestorage medium according to claim 11, wherein said apparatus is used incombination with a microscope, a slit lamp, an OCT, a microscope, adirect or indirect ophthalmoscope, a microperimetry device, or anexisting fundus camera.
 14. The non-transitory computer readable storagemedium according to claim 11, wherein said apparatus is used indetecting amyloid in said retina.
 15. The non-transitory computerreadable storage medium according to claim 14, wherein said apparatus isused in said detecting of amyloid in said retina utilizing lightsources, filters, spectrometer and sensors that allow curcuminfluorescence enlarging, auto fluorescence imaging, hyper spectralimaging, multispectral imaging, or OCT and subsequent image segmentationto identify amyloid associated with either ocular or brain conditions.